My Wagon is Stuck in the Mud....

“When our wagon gets stuck in the mud, God is much more likely to assist the man who gets out to push than the man who merely raises his voice in prayer—no matter how eloquent the oration.” ― Dieter F. Uchtdorf

What a week.  And this quote came at a very opportune time.....a very opportune time.

So here's is how we are going to do this, I'm going to give you a day to day version of events....otherwise known as "THE RIDE"....then I'm going to tell you about the journey....because they are two ENTIRELY DIFFERENT things!

Let's start with last Sunday.  Since we are on Saturday, that makes for a pretty nice week recap....don't ya think?

SUNDAY
-Baylee couldn't hold her head up.
-Noah had a massive meltdown (hello pre-teen).
-Someone left the freezer open...and ALL of the food had to be thrown away.

MONDAY
-Spent the day talking to doctors talking about post-surgical issues and causes for the head stability problem
-Baylee calls from school telling me she hurt her leg
-Spent the evening in Urgent Care
-Missed Savannah's volleyball tournament

TUESDAY
-Drove to St. Louis and spent the day at Children's Hospital ER, just to find out Baylee has a hip fracture
-Made it to Savannah's volleyball game

WEDNESDAY
-Coordinated Baylee's missed school work
-Spent the day on the phone arranging doctors/appointments/coordination of care for her arthritis

THURSDAY
-Drove up to St. Louis to meet with Orthopedics and confirm Avulsion Hip Fracture
-Sewage back up in the basement (yup, second one this year)
-Late night (yes, I count 9 pm as late) piano/choir practice

FRIDAY
-Cried to everyone who would listen
-Fought with Landlord over who's fault the sewage was
-Retained an attorney (just in case)
-Had temporary crown replaced with my real one!  YAY!
-Had entire basement (that had just been rebuilt in March) ripped out
-Spent the night at a hotel

SATURDAY
-Volunteered at concessions for....
-Soccer, soccer, soccer in the rain
-Anxiously waited for Felix to get home from his business trip to Europe

Whew!  What a week!!!

So now we know what happened on the ride.  Let's talk journey...shall we??

I really, really, REALLY hate to admit this...but it has been an extraordinarily bad week.  And I have struggled.  And I HATE struggling.  I honestly feel like I have only been able to tread water.  

On Sunday, I was already ready to throw in the towel.  Felix was gone, he had left on Friday night...and with the time difference to Europe, I knew I was largely on my own this week.  So everything that was wrong seemed HUGE.  Don't get me wrong...a kid (that had jaw surgery 5 days ago) telling you she can't hold her head up, was a big deal.  Losing everything in the upright freezer, was a big deal.  But let's face it....I have weird big deal type stuff happen all of the time....it's just kind of how I roll.  But still....I didn't want to deal with any of it...and the biggest part of IT was yet to come.

And I poured my heart out in prayer Sunday night.  At least, at the time, I thought it was pouring my heart out....in retrospect....I was going through the motions to a certain degree.  I pour my heart out....tell me what to dooooooo.....but I don't think I was asking the right questions.

So when Monday rolled around, I got all of the kiddos off to school, ready to make the week better than it had started.  I talked to the doctors...and one of my feel good moments of the week....they agreed that my assessment of what was going on with Baylee's head, was the most probable answer to her struggles (i.e.  In all likelihood, as the fluid was moving around and decreasing and the swelling from the injection sites was going down, her muscles hadn't yet contracted....so she was feeling like her head was loose, had no strength....or as we termed it, "a bobble head").  I felt kind of validated.  Then about 40 minutes before the end of school, she called to tell me she hurt her hip, and come get her.  Sigh....really?

So I go to see what the deal was, and immediately even I knew that something wasn't right.  I thought she had dislocated her hip.  Although, mean mom that I am, made her wait until school was out and the boys were out (because I wasn't checking them out), then I would take her to the doctor.  Savannah was headed to a volleyball tournament, and she had to go with a friend.

I dropped the boys off at home, and off we went.  I told the Urgent Care what I suspected, they said they couldn't help her and I told them I just wanted x-rays so there would be something to compare when we went to Children's Hospital the next day.  They obliged.

When the x-rays came out, I was already on the phone with orthopedics arranging for an assessment.  The soonest they could get us in was Thursday...that was with the Nurse Practitioner BEGGING for her to be seen sooner.  Oh well.  At least I had my x-rays.

That night, I was just blech.  I was still frustrating from Sunday and really just irritated at the world.  I couldn't believe this was happening while Felix was out of the country.  Seriously.  I was mad at his job, and mad at the circumstances...just....plain....mad.  Oooohhhh, I was in a mood.

But we made it through the night.  As I was saying my prayers, once again I thought I was pouring my heart out...pleading for help.  And I was.  At least I thought it was.  But in hindsight....again....I think my Monday night prayer, was pretty similar to my Sunday night prayer.

I had gotten in touch with Felix earlier in the day, filled him in on everything, and we decided that I really would follow up with my plan to take Baylee up to Children's ER the next day.  

So on Tuesday morning, I dropped the other three off at school and Baylee and I made our trek to St. Louis.  We did x-rays right away.  And I was somewhat surprised when they said Baylee's hip wasn't dislocated.  I was even more surprised when they said it was broken.  I think I might have thrown up a little in my mouth....for reals.

Armed with crutches, percocet and our appointment with the Ortho on Thursday, we headed home.  Baylee on Percocet is funny.  She is most definitely not meant to be a spokesperson again drug use.  Baylee is not the most affectionate kid.  She isn't prickly or anything like that...but she just isn't affectionate.  On the ride home, I got to hear about how much she loved me, the rest of the world and Peanut Butter.  She really, really, REALLY loves peanut butter.

I had to have someone else pick the kiddos up and take them home.  Savannah had another game.  So I got Baylee home.  Gave the boys strict instructions on how to take care of Baylee and drove to Savannah's game, which happened to be 30 minutes away.  I was a little tired of the car at that point.

I was distracted during the game (Gee, I wonder why), felt guilty, and was so grateful when we went home.

We made it through another night.  Although, thanks to the percocet....it was an easier night.

I also think that I talked to Heavenly Father more earnestly.  I needed help.  I needed His help. I was overwhelmed.

Got the kiddos to school Wednesday morning, and headed to school to set up all of her school work and how we were going to handle things.  Went to chapel with the boys...and spent the day with Baylee, catching up on laundry and all the parts of life that I had to set aside.

Honestly....I know other stuff happened.  Probably stuff I want to (but don't necessarily need to) talk about happened....but for the life of me, I can't remember what.  I just know I was hanging by a thread, and putting one foot in front of the other.

Head back to St. Louis on Thursday.  I needed food at Costco, but we didn't really have time.  It drove Baylee nuts, but I did stop and get water.  I can't live without my water.

At the doctor, they confirmed the diagnosis of the ER.  But because of all of Baylee's underlying health conditions, we have to take this slowly.  She gets a wheel chair for when she returns to school (which has been the most awesome toy at the house), no weight on her leg for 2 weeks and when she is "ready"...lots and lots of physical therapy!  Woohoo!

When we got home, we found a half eaten lizard in the basement.  And our usually very reclusive cats, were circling around.  I don't know if that meant they were hiding and getting ready to eat the rest or what.  Psycho cats.

Needless to say, I was still having that overwhelmed feeling.  Got home.  Got Baylee settled.  Had all of the arrangements for wheelchairs and fun made.  I talked to Felix and told him how much I was struggling.  I didn't feel very close to Heavenly Father....I didn't understand why all of this was happening.  I didn't feel like my prayers were being answered....I just felt like I was failing.

Then a great friend posted President Uchtdorf's quote, "“When our wagon gets stuck in the mud, God is much more likely to assist the man who gets out to push than the man who merely raises his voice in prayer—no matter how eloquent the oration.” ― Dieter F. Uchtdorf....and I got a little perspective.  I had been praying my little heart out.  But what had been doing, other than just surviving.  Well.....nothing really.  

And I begin to think.  I can do this.  This is crazy...I know this is crazy....but it didn't mean I shouldn't be doing something.  And the first thing I needed to do, was change my attitude.

So we tried to take it easy.  Just chill.  And then the smell hit.  I couldn't figure it out.

Finally, I went down to the basement (where I had been a kabillion times already that day) and guess what.  A sewage back up.  Only this time....it was worse.  I got all of the musical equipment moved.  PHEW!  Because we have priorities.

And my attitude went down the can.  I called my mom and repeated over and over, "I'm done."  I can't do this anymore.  I broke down.

Then I took Noah to play piano.  Then I came home to the stench.  It was a long night.  It was a long night because I felt so trapped.  Baylee was difficult to move.  Felix was out of the country, already asleep and impossible to reach.  I don't want to go into much detail....but the back up was bad enough, that we had to take on the mantra of, "If it's yellow, let it mellow.  If it's brown...yeah, that stays too."

And I prayed.  And I prayed and I prayed.  

And Friday, I got the three kiddos to school.  The plumber came and augured the main line (which was once again 65 feet outside of the house) and cleared the clog.  His words were, "I don't think it's anything you guys are doing."  Let me give you some context, when we had our first sewage flood, our landlord asked us if we were "excessive wipers".  Yes...you read correctly.

Then Felix talked to the landlord, who appropriately flipped out.  It was appropriate until he asked us if our kids were shoving paper towels down the toilet....

So then the back and forth began.  I updated our landlord once the drain had been cleared.  We tried to find out when we could get the disaster company started.

And I called an attorney.  And we discussed how Missouri law really, really favors the landlord.  And the fact that my children had auto immune diseases was pretty much irrelevant.  It wasn't the best conversation in the whole wide world.

And then the landlord called me to tell me that he wasn't going to proceed until the plumber called him back and answered his questions.   I told him about the conversation I had with the plumber, and he said it was supposed to have been fixed in January....yup, it was.  So I called Felix (because the landlord and I are like oil and water) and had Felix call him to find out when we could get started.  I called the plumber and begged him to call the landlord.

The landlord pretty much told Felix he needed insurance to cover it, and he wasn't sure if they would because it was the second flood in a year.

So I did what any normal person would do.  I cried.  And I called my mommy.

And then at 5, the landlord called to tell me the work was approved.  5 minutes later, Servpro showed up.  Sadly, they remembered the first flood and knew where everything was.  Sigh.

The finished at 9:30, and the kids and I headed to the hotel.  The smell was much better....but I needed to not be in the middle of the mess anymore.

And I prayed.  I prayed with my whole heart and soul.  And I still felt like I was struggling.  I didn't know what to do.  I didn't know where to turn, what to think, what to do.

So the five of us, snuggled up in our room and slept.  Then we had to get up early, because it was soccer day, and I had volunteered to do concessions forever ago....

I dropped the girls off at home.  And off to soccer we went.  I did concessions.  Watched Caleb's game.  Pondered, thought, prayed.

And the thought for the day was, "Is Heavenly Father telling me it's okay to move on? or is Satan telling me he will do everything in his power to get me out of here."

A wise friend of mine said....why does it matter, they are both telling you the same thing.  

Of course, my thought was, "That's a scary thought."

My biggest worry though, is that I am so dark and dreary on the inside I'm not listening to the right person.  And it scared me.

So I got home from soccer.  Went to the store.  Pondered some more.

When I got home from the store, got everything put away, I decided to waste some time on Facebook.  And I got my answer.

"Do not murmur, my son, for it is wisdom in me that I have dealt with you after this manner."

Doctrine and Covenants 9:6

And there you have it.  My "Well duh." moment.

What have I been fighting against?  And what on earth have I been waiting for?  A road paved with gold?

My word.  Have I ever not thought that Heavenly Father knew what he was doing?  Obviously, that is where I was this week.  I was fighting to put my will over His.  And why?  Do I know better than Him?  Absolutely not....but stubborn, prideful me sometimes thinks I do.

So here I am on a Saturday night.  My husband is back in the country and almost home.  They didn't take any of my presents away in customs (YAY!)...and I know I'm going to be okay.

Lessons Learned

1.  I never thought I was prideful before, but I am.  I think I'm smart and clever and I can get through anything.  Sometimes I forget I don't get through it all on my own.

2.  Grateful that Heavenly Father sees through my failings over and over again to teach me those lessons I so desperately need.

3.  True friends are those that stick with you, support you and tell you they were just waiting to get their on your own because it means so much more than when someone just gives you the answer.

4.  When you are mad, the words "I'm done." mean something totally different.

5.  It's when "You're done." and you surrender and actually LET Heavenly Father give you the blessings that you truly GET them.

WE ALL FALL DOWN!

This has needed to be written down for a few weeks.  However....if you are one of my friends that drinks, you may not find it so funny.  But for us non-drinkers....it was freaking hysterical!

My kids started school on August 15...a Wednesday.  By Friday, I already had one kid staying home puking their guts out.  Sigh.  So Felix stayed home (wait....he works at home....when he is home....) and helped me get some schtuff done.  For some reason, I cannot seem to catch up on life.

We picked the other three up at school and came home.

When we got to our house, there was a lady sitting on the side of the road holding on to her 2 dogs (they were absolutely adorable!).  So since the lot across from us, and the lots on either side of us are empty, and it is unusual for someone to just be sitting on the side of the road, I asked Felix to check on her and make sure she was okay.

He went and introduced himself and asked if she was ok....and of course, Savannah had to go and help.  They talked to her for a few minutes and I got tired of waiting, so I went over to see what was going on.

"Well," she says, "I never should have tried to walk both dogs at the same time."  She looked a little wobbly, but was talking just fine....so we kind of just chatted for a moment, asked her if she needed help and she said no.

So the three of us went in to the house....okay, the garage.  We were talking about how weird that was, when we heard the dogs leashes dragging along the ground and they came tearing into our garage.  Then they went over and peed in the yard.

The woman came up and said, "Sorry, shorry, I'm sho shorry."  We told her it was no big deal, we have a dog, I'm sure they smell her and they are just marking.  Dogs pee in the grass....hey!  Whaddya gonna do????

She continued to apologize...then promptly fell flat on her face in my driveway.  And I don't mean, she tried to not fall or even catch herself...she fell flat on her face.

I hurried over and helped her up, while Felix tried to catch the dogs.  When we got her up she had cut her face in two places.  So we sent Baylee to get tissues.

At this point she was slurring her speech so badly, we couldn't understand her.  So I told one of the kids to call 911...then told them wait, because she shook it off a little bit.

We asked her where she lived....and lo, and behold....she lived right across the street.  Awesome....we've lived here one year, and the first person to talk to us is the intoxicated lady.

As we start walking toward her house, she promptly falls flat on her face again....thank goodness this time it was in the yard.  Phew.  I helped her up and we started to cross the street.

And down she goes again.  This time she didn't just fall....she managed to skkkiiiiiiiidddddd.  All down one side of her face and her knees.  Whatever she drank or ingested, seriously rendered her arms useless.  I'm just sayin'.

So I help her up....try and wipe up some of the blood, and keep going.  She fell in her driveway too.....but I caught her....and I would just like to say....that was no easy task.

We made it up her driveway and rounded the corner of her sidewalk towards her front door, where she fell into the bushes.  And I mean into.  I had to pull her out from between two bushes....it was more like an extraction....I'm pretty sure the bushes were trying to eat her ('Feed me Seymour').

We made it to the front porch!  YAY!!!!  And then she fell into the bushes on the side of her porch.  She did manage to rebound off of the bushes this time (instead of plunging straight through them).  Unfortunately....she rebounded on to the column on her porch....with the other side of her face.

So as she is bleeding all over her porch, we are trying to find out if anyone is home or if we can call someone to come and be with her....and she keeps saying, "ohhhhhh, he's in there.  he just wont answer" and we heard that slurred little mantra over and over again.

We finally offer to walk her to the door through her garage (which we just realized was open).  The dogs go in and she shuts the door and offers to walk us home....ummmmmmm, no thanks.  The she starts crying and telling us about how she is having a bad day.....and then she starts telling us about how awesome we are and that we love her dogs ("Do you want to walk my dogs....because you love my dogs.".

We tell her to go and lay down and we will check on her in a little while.

We get all of the way home, when I realize I am still holding on to her cell phone.  Aw crap.  So because I don't want her walking around, I just leave it on the porch and bolt home.

Then we decide to call the police....because she's alone....we think....and if nothing else....she was pretty beat up and probably needed some medical attention.

So as I am calling the non-emergency number and talking to the dispatcher, her husband pulls up in the driveway.  I told dispatch and we called it good.

So what did we learn from this little experience????

Lessons Learned
1.  When we went in, we gathered the children and said, "This is why you don't drink."
2.  It's good to have an ex-policeman father....we are pretty sure we are covered under the good Samaritan laws.
3.  The lady hasn't spoken to us since.  Either she doesn't remember us or we are only fun when SHE is drinking.
4.  If I ever feel lonely, and need to be needed....I'm totally going to a bar.
5.  It actually is really sad....and she finally came out of her house....so we think she is all better now.

What a Year!

This is about 13 days overdue.  I had planned on writing this and posting on August 1st....oh look!  I didn't!  There should be no shock there!  Running late is like my new thang!

But here it is....better late than never!

One whole year in Missouri.  One whole year out of Utah, and away from the only home my kids had ever known.  And what a year it has been.

I'm gonna be honest  It has, by and large, been a pretty rough year.If you really want to know....down right crappy in some parts.

But.....in the face of all of this adversity, there have been some lessons.  Would I be me if I neglected to point out the lessons that have come through adversity?  Not so much.  So here goes!  (And since my whole blog is about lessons....we are going to skip my little lessons at the end!)

Lesson #1:  My kids are FREAKING AWESOME!
My kids have been asked to endure a lot!  And I mean a lot!

There has been much emotional turmoil in my house the past year.  Some because of physical trials.  Some caused by the hands of others.  And some caused by ourselves.

And through it all, I have watched my children learn and grow.  I have watched my children look adversity in the face, and not back down (and even I will admit they have had plenty of reason to back down).

I have watched them suffer at the hands of others and continue to choose the better part.  It hasn't been easy for them....but they have each (clear down to Caleb) taken every situation that has been thrown at them, and turned it into an opportunity to learn and grow.

Wow!  There really are no words to described how impressed I have been with my kids.

Let's be honest though, they aren't perfect.  They fight.  They are slobs.  But they are also good souls.  And I am awestruck that Heavenly Father entrusted them to my care (because I am afraid that I might really mess up what He intends for them!).

Lesson #2:  My husband is FREAKING AWESOME!
Felix has had to support my crazy, the kids crazy and well, just the general crazy in life....all while doing amazing things at works, travelling more than we thought and making a grand enough impression to be made the global CFO of his division.

Yeah, he is that freaking awesome!

He has spoiled me rotten!  Taught me love and patience as I have struggled through my personal trials....and most importantly, he loves me.

How grateful I am that Heavenly Father blessed me with such an incredible gift....my husband.  With all that we have been through, he has given more than any single person should be capable of giving.

Again....how humbling to have such a blessing.

Lesson #3: You can teach an old dog new tricks.
My poor mother can attest that the majority of my phone calls have started out with "I have been humbled once again!"

Let's just say that I didn't realize how too big for my britches I had become.  I had no idea (yes I am Captain Oblivious!) how narrow minded I had become.

My view on the world has significantly changed.  I hope that I am no longer that judgmental, single minded personal I was.

I truly hope that my capacity for tolerance has grown by three sizes (at least!  If the Grinch's heart can grow, so can I!).  I have learned so much from people around me!  People who believe things similar to what I believe....people who believe nothing remotely like what I believe....and people who, well, there are people who just march to the beat of their own drummer, aren't there!?

And yet again, I have much gratitude that I didn't live my whole life in my bubble....and miss out on soooo many experiences to learn from others!

Lesson #4:  You don't have to like what is around you to be happy!
War is hell.

Life is war.

My family is stinking hysterical.

And we have learned to laugh in the middle of all of the crazy...and keep laughing.

Lesson #5:  You don't have to think you are worthy to get blessings.
If we were required to think we are worthy of blessings, well, we would all be waiting for a long time, wouldn't we....

The answer to that question is yes.

In His infinite wisdom (and mercy....yes, I have been a recipient of mercy...a lot lately), God realized that the majority of us wouldn't never think we were enough.  Enough for others, enough for our selves, enough for Him.  We don't have to worry about that though.

Simply put....'Even if you stopped believing in Him, He has never stopped believing in you.'

With God, all things are possible.  Even surviving a particularly difficult year.

Following the Leader....?

We made our trek from Missouri to Wisconsin last week.

2 Cars

2 Parents

4 Kids

1 Poodle

and an

Assortment of life crap we couldn't live without

Let's just say it was eventful.  We switched cars twice....had to make sure the dog was getting enough water....yada, yada!  

So with 2 cars, it meant one of us had to take the lead...future note....update the maps on the GPS', so that we aren't trying to go in different directions!

But while we were wending our way across 3 states, I started to think!  OH NO!  We all know that usually ends poorly for me!  This time, I was noticing the different driving styles Felix and I had.

I realized how much better Felix is at....well....everything (except maybe shopping at Amazon [Yes, Keara....I am the master!]).  But driving, and because I'm me, I managed to turn something as simple as an 8 hour road trip into a metaphor for life!

FELIX AS A LEADER

As much as I hate to admit that anyone is better than me....dang pride....Felix is a way better leader than I am (until he gets to the end).  He was also so careful to make sure not to go to fast.  He would always signal way, way, WAY in advance to make sure that we ended up in the same place.  He even called me a couple of times to make sure I knew where I was going.

WENDY AS A LEADER

You've got your own GPS....EAT MY DUST!

FELIX AS A FOLLOWER

Calm, cool, collected.  Comfortable and confident in the direction he is going, he didn't stress if I got too far ahead, but typically kept up and stayed where I could see him in my review mirror.  

WENDY AS A FOLLOWER

YOU WILL NOT BEAT ME!  YOU WILL NOT LOSE ME!  Yeah, that's right....don't try and sneak away....Never more than a car in between us.  CAN'T....USE....CRUISE....CONTROL....ohhhh noooo!  I'm too erratic and spastic for that!

So uh....anyone that knows our personalities, should see the parallels in driving styles to who we are. If you don't....well, you don't really care then, do you?

Lessons Learned

1.  I obviously need to learn to follow.

2.  Oh hey!  I need to learn to lead too.

3.  The adventure is really going to be when I am on the road on my own with the kiddos and the dog.

4.  I don't make stops, unless I of course, request them.

5.  The adventure lives on!

Nine Months....and GAINING

Wow!  I know it's been a while.  The world has been somewhat a topsy, turvy place lately.  I'll give everyone a short, short version of events and then I'll get into the body of my post.

In case you hadn't heard.  We won our legal battle with United Healthcare.  It was touch and go for a while and I couldn't wrap my brain about how to pay for future care and the $21,000 medical bill created by just the first 3 months of this year.  However, Heavenly Father saw fit to intervene and softened some hearts that had the power to fix this for us.  Our bills have been paid (although United alternates...still...in between sending letters of rejection and letters of apology), the hospital still likes us and although we didn't share this with United (it was need to know...AND THEY DIDN'T NEED TO KNOW), Baylee has switched medications and we are in the scary part of treatment where we wait and watch to see how her body reacts.  Also adding to the fun, her new medication may or may not treat her eye condition (for more information on that, I happily direct you to http://www.pinkburstproject.org).  So we wait and we watch and hope and pray that if the medication doesn't work, we catch it before permanent damage is done.

Noah has turned 12, received the priesthood and was made a Deacon (for all of my non-LDS friends, message me and I will be happy to share more on what that means) and happily gets ready for church EARLY on Sunday's because he loves the privelege of passing the sacrament.  He is definitely 12 and girls are on the radar.  He asked me the other day who Kate Middleton was.  I explained she was married to Prince William and asked why he wanted to know.  He said she keeps popping up on Yahoo!.  I said oh.  I don't think he knew I was listening (although I have mercilessly teased him about it since), but I heard him softly say, "I love Yahoo!."  Love it!

Caleb just turned 7....making me feel very, very old.  Next year when he turns 8, I may have to have plastic surgery because I will be in so much denial about how old all of my babies have gotten.  He was concerned that he needed to shave for his birthday....but I told him he was good.  He is as loud and adventurous as ever....and if I can keep he and Noah from fighting over anything electronic, I would be amazed!  They also share a room now, and when they aren't getting along, they lock each other out and invariably one of them sleeps in the hall.

Savannah is 14.  I hate 1 Direction.  It is Savannah's fault I hate 1 Direction because that is all she ever talks about....no....that isn't fair.  She also talks about her friends that like 1 Direction.  (**Side note:  all of my cute pinterest friends...stop posting 1 Direction on pinterest....you're messing with my page!  :))  When she isn't bothering me about 1 Direction, she is studying, hanging out with friends and pestering her teachers about how she can start taking classes this summer so she can graduation 1-2 years early because she really, really wants her Bachelors Degree early.  If any of my children can do it, she can.  She attend the high school here (she is in the 8th grade) for math, and was invited to participate on the High School Math Team for a competition.  Although she didn't place....I still think it's pretty awesome that she was asked to be on the team.

Felix is working and travelling.  And working and travelling.  And when he isn't working and travelling, he is travelling and working.  He has to spend quite a bit of time in Wisconsin for the next few months, so as soon as school is out, we are going to be groupies and start following him on the road!

Me?  I've been keeping it all together, getting new renters, finishing my Personal Progress, driving to and from the hospital and quite frankly....asking Heavenly Father lots and lots of questions.

So...PHEW!  That wasn't as short as I wanted it to be....but hey, there has been a lot going on and I have left a TON out!  But given the sheer insanity of the last few months, I just have to get this out.

When we made the decision to come to Missouri, we prayed, we fasted and knew that this was what we were supposed to do.  BUT....we were coming for "The Job".  "The Job" is what pays the bills and  hey, people work for money not fun (and if anyone tells you different....they're lying!).  Well, since Felix wanted to stay employed and I wanted to be able to pay bills, we just needed Heavenly Father's blessing to come and we received it.  Soooooo, we came to Missouri for "The Job".

However....little did we know (and by 'we', I mean me), how much more was in store for us.  Moving was not JUST for "The Job"....it was for me and my family....because we needed to stretch and grow.

"THE JOB"
Let's talk about "The Job" first.  Oooohhh, so many promises were made to get us here.  Felix wasn't going to travel.  His work schedule would normalize and he was going to have so much more time for the family.  You can see where this is going...right?  Well....he is gone more now than ever before.  Sigh.  We miss him.

"THE JOB" Helped Us Gain
But what have we gained?  Oh my...we appreciate each other SO much more than ever  before.  We make the moments count (instead of counting the moments).  We could have all the time in the world, but if we didn't use it, it wouldn't matter.  It matters....it matters to us!  Time with each other...exploring, talking, laughing, learning....we may not have a ton of time together, but the time we do have his richly filled with love and enjoyment!

"SCHOOL"
Let's talk about "School" now.  "School" has been rough.  Savannah was threatened, Noah was ostracized, the school ignored Baylee's 504 (her disability documentation), and Caleb was beat up and emotionally abused until it physically took a toll.  "School" was very, very scary there for a while.  But I would like to point out....it WAS!  What have we gained?

"SCHOOL" Helped Us Gain
Yeah, I give snippets on Facebook.  And most everyone knows my funny little Mormon kids go to a Lutheran school....and let me just share....WHAT A BLESSING it has been.  The kids are happy, well-adjusted (for my kids) and learning!  They come home happy, keep their grades up (mostly), and look forward to attending.  We have learned that being "Mormon" or "Lutheran" doesn't mean you are good or bad....that is up to the individual and the choices they make.  My children who had thus far grown up in a very sheltered Mormon environment have learned to be comfortable with their faith....and it is their faith.  Even Caleb has learned to pray for guidance and direction while he is learning Lutheran doctrine at school and Mormon doctrine at home.  We have gained many opportunities to discuss faith, and how faith doesn't belong to one religion or another, it's a personal thing.  We have gained opportunities to explain that people who do not believe as we do, or who make choices that are different than our are not 'bad', simply different...and that most importantly, it is not our place to judge.  Our job is to love.  And we are learning to do that whole heartedly (all of the time...with other people....it's a little harder with family :))

"CHURCH"
Church and the Gospel are 2 different things.  Did you know that?  Did you know that while the Gospel is true, people still have free agency and are able to choose actions for themselves.  This means that people have to learn right and wrong for themselves.  They have to learn good and evil for themselves.  Which can sometimes cause immense sadness, for themselves and others.

Can you tell I've been under stress lately?  That I've dealt with some things inside the church that took me by surprise?  Yeah.  And no....I'm not going to discuss.  Let's just say that my heart still hurts.  Sometimes I'm still surprised by the things that have transpired.  Sometimes I wonder what the heck happened and how did I get here.

"CHURCH" Has Given Me
I had a testimony before I came.  I did.  I trusted Heavenly Father.  Although, I am still me and love to question (even after I received answer....I'm the girl that says, "Are you sure?"), I trusted that Heavenly Father would answer my prayers, guide and direct me and then let me make my own choices (even if it was different than His will).

So what has this all gotten me.  My testimony is now made of stone.  I know who is in charge (and no, it isn't me).  I know that MY prayers are heard and answered by a loving Father.  I know that He knows who I am.  I know what it feels like to make stand.  I know what it feels like to stand alone (although I always feel funny saying that because I know I am never alone).  I know what it means to plead for understanding, patience and charity.   I know what it means to beg for forgiveness for my failings. I know what it means to have to separate my thoughts from the whispering of the Spirit.  I know what it is to feel peace in the midst of a storm.  I know that I will never "be enough" for anyone or anything...but I do know that as long as I am trying to do what is right, my shortcomings will be made up through the Savior's Atonement.  I suppose I can easily sum things up with 2 words....I KNOW.  I cannot deny the gentle, yet sure answers I have been given.

So...the adventure lives on...right?  Yeah....it lives on....but now, I'm gaining on it!

Lessons Learned
1.  There are so many...where to I start?
2.  I am lucky to be me.
3.  Because I have been blessed with amazing angels called friends.
4.  I am blessed with guardians called my family
5.  I am blessed.

So Here It Is!

So....this is it.  This is what our second tier appeal to the health insurance coverage hinges on.  The irony of the entire situation is that Baylee had "surgery" yesterday.  Aspirations (the withdrawal of fluid from her joints) and the injection of steroids directly into the problem areas.  They don't usually do more than 4 joints at a time, yesterday they did 6.  She had a team of 7 doctors and nurses.  United won't pay for her medication or treatment....but they will pay for that.  Go figure!  Wish us luck!!!

March 26, 2012

United Healthcare

Attn:  Appeals Department

PO Box 30432

Salt Lake City UT 84130-0432

RE:     Subscriber ID:            908007314                            Group/Contract:        192961

            Patient:                    Baylee A. Morgan                Date of Birth:            06/11/2001

            Diagnosis Code:       714.32                                    Procedure Code:      J1745

            Date of Service:        01/11/12; 02/07/12  

To Whom It May Concern:

I am appealing the denial of claims submitted from CH WUSM Ped Diagnostic on dates of service 01/11/12 and 02/07/12 for Baylee Morgan for the following reasons:

1.    Good Faith:  Treatment was pursued based on assurances by United Healthcare Employees that the procedure and diagnosis were covered.

2.    Covered Under Previous Insurance Plans

3.    Medical Necessity: A proven history of the failure of other TNF inhibitors.

2012 Coverage - Good Faith

We switched insurance to United Healthcare as of January 1, 2012.  Sue Price, the insurance coordinator with Rheumatology department at St. Louis Children’s Hospital called to authorize her treatment and received verification of coverage.

Baylee received her first Remicade infusion on January 11, 2012.   We received a denial for the treatment at the end of January.

The denial listed diagnosis code 364.01 (Primary Iridocyclitis) which is the diagnosis code for Uveitis and Iritis.  I called and spoke with Sue Price, who agreed that the code should have been 714.32 (Juvenile Idiopathic Arthritis), and that they had already begun an appeal process and were conducting a peer to peer review with United Healthcare.  Sue said it is not uncommon to receive denials at the beginning of the calendar year, and to go ahead with the next treatment as it was likely just a diagnosis code error.

Baylee had her second Remicade treatment on February 7, 2012.  We received our denial of appeal near the end of February.

As part of my process of appeal, I called several times, speaking to several different employees of United Healthcare.  Following is a chart of dates, individuals and conversation notes.  All phone calls were initiated by me.

Date	Dept./Employee	Conversation
February 24, 2012	Appeals	Instructed me on appeals process.  I asked what Remicade was approved to treat and was transferred to the UHC pharmacist (Chris), who said he didn’t know why I was transferred to him and he couldn’t help me.
February 24, 2012	Member Services / Vanessa	Verified diagnosis code 714.32 and procedure code were covered.  Confirmed both codes were covered.  Specifically asked if JRA was excluded and was told it was not excluded, that Remicade was APPROVED treatment for JRA.
February 24, 2012	Member Services / Barb	Explained issue, said I had additional questions.  *Disconnected*
February 24, 2012	Member Services / Stephanie	According to plan documents, Remicade is a COVERED procedure for treatment of JRA.  Verified code 714.32 was used for billing.  She said she didn’t know why it was denied.  Stephanie talked to her supervisor who suggested I be transferred to Rapid Resolution Claim Center to have claim fixed.
February 24, 2012	Rapid Resolution Claims Dept / Kira	Confirmed appropriate billing code and procedure code.  Kira said claim had to be processed manually, not automatically.  She flagged both claims, said they would both be paid and that new EOB’s would be issued within 10 business day.  She said she also flagged the account so we wouldn’t have any issues the rest of the year.

Both claims were denied again on February 27, 2012.

Date	Dept./Employee	Conversation
February 28, 2012	Rapid Resolution Claims Center / Karina	Told her I was told claims were covered and asked for explanation of denial.  She said the notes said it was not approved.  Asked her for a list of Remicade approved treatments, she said it would take 5 business days to figure out how to do that.  I asked to speak to a supervisor because the information was necessary for appeal.  She said there were no supervisors available and one would call me back in 24-48 hours.
February 28, 2012	Member Services / Susie	Asked for copy of what Remicade was approved treatment for.  She was unable to find a way to get me the information.  She said according to plan documents, Remicade was APPROVED treatment for JRA.  Suggested a second level appeal.
March 1, 2012	Member Services / Unknown Male	Said there is no such thing as a Summary Plan Document.  I asked for information on how they knew what was covered he said it was all programmed in the computer.
March 1, 2012	Member Services / Ramona	Asked for supervisor from Rapid Resolution Claims center because they never returned my call.
March 1, 2012	Rapid Resolution Claims Center / Sharina	Sharina said we could get a copy of our Summary Plan Document from Aon or benefitsnow website for Henry Schein.  Sharina said the procedure is a COVERED procedure, but not for all diagnosis codes.   Sharina confirmed that procedure code J1745 is approved to treat 714.32.  Gave me the phone number for Claim Coordination Dept to verify.
March 1, 2012	Claim Coordination Dept / Lisa	Verified procedure code J1745 was approved to treat 714.32.  Lisa said notification is not required and to re-verify benefits through Member Services.  Transferred.
March 1, 2012	Member Services / Mitch	Verified J2745 is APPROVED to treat 714.32.  Gave following benefit information: Outpatient covered at 85% Office Visit covered at Office copay amt. Out of Network covered at 70 %

Based on information provided from United Healthcare, we continued forward with Baylee’s treatment on March 13, 2012.

We ask you to reconsider the denial of payment for the Remicade treatment on Good Faith effort on our part to verify coverage.

Covered Under Previous Insurance Plans

Baylee received Remicade treatments for almost a year and half with no opposition from previous insurance companies.

Date	Insurance Carrier	Status
July 7, 2010	Intermountain Healthcare	Covered / Paid
July 20, 2010	Intermountain Healthcare	Covered / Paid
August 17, 2010	Intermountain Healthcare	Covered / Paid
October 16, 2010	Intermountain Healthcare	Covered / Paid
November 20, 2010	Intermountain Healthcare	Covered / Paid
December 18, 2010	Intermountain Healthcare	Covered / Paid
January 15, 2011	Intermountain Healthcare	Covered / Paid
February 12, 2011	Intermountain Healthcare	Covered / Paid
March 12, 2011	Intermountain Healthcare	Covered / Paid
April 9, 2011	Intermountain Healthcare	Covered / Paid
May 21, 2011	Intermountain Healthcare	Covered / Paid
June 18, 2011	Intermountain Healthcare	Covered / Paid
July 16, 2011	Intermountain Healthcare	Covered / Paid
September 1, 2011	Cigna	Covered / Paid
September 29, 2011	Cigna	Covered / Paid
October 26, 2011	Cigna	Covered / Paid
November 22, 2011	Cigna	Covered / Paid
December 20, 2011	Cigna	Covered / Paid
January 11, 2012	United Healthcare	Denied / Appealed
February 7, 2012	United Healthcare	Denied / Appealed
March 13, 2012	United Healthcare	Denied March 23, 2012

Medical History

In May of 2003 Baylee Morgan was recovering from pneumonia, when she suffered a fall down a 2-3 stairs.  Her knee became swollen and she had difficulty walking.  Over a period of days, she regressed from a busy, active toddler to a child who needed assistance to walk, then becoming unable to walk at all.  After a series of tests, her condition was still unknown.  We were sent to an orthopedic surgeon to check for any abnormalities in her knee. 

On June 11, 2003, the orthopedic surgeon found what he termed a “tumor”, or unknown mass within her knee joint.  He was able to get us in to Dr. Lor Randall, an orthopedic oncologist within a period of weeks.  Upon initial examination, he felt biopsies of the affected areas were necessary, and felt certain it was likely cancer.

When the biopsy results came back, there was no sign of cancer, but all areas biopsied showed severe inflammation.  We discussed the possibility of arthritis, but Dr. Randall deferred to Dr. John Bohnsack, Pediatric Rheumatologist, for an assessment

We met with Dr. Bohnsack in August 2003, where he confirmed diagnosis of Juvenile Rheumatoid Arthritis (JRA).  Dr. Bohnsack noted that several joints were involved (toes, ankles, knee and elbow), and immediately started her on an NSAID, Naproxen

At her six week follow up examination, the Naproxen, while helping slightly, had not done enough to reduce the pressure of the inflammation on Baylee’s joints.  In September 2003, Baylee began a weekly subcutaneous injection of Methotrexate.

The Methotrexate showed positive results, and while it was adjusted from time to time to accommodate her growth and progression of her disease, was considered all that was necessary for treatment at the time. 

At age 3 ½ (approximately) she was diagnosed with Uveitis, and later Iritis.  Baylee’s eye conditions were treated separately with an Ophthalmologist.

In the first few years of the Methotrexate treatment, Baylee entered remission of her disease, but upon discontinuation of the medication, the JRA returned.  Shortly after the return of the JRA, there was a shortage of injectable Methotrexate and Baylee was switched to oral Methotrexate.  Baylee was more resistant to the oral version of the drug, and began to physically regress.

Upon renewed availability of the injectable form of Methotrexate, and an increase in dosage to accommodate her growth, Baylee once again began to show improvement.

In July of 2005, at a regular examination from Dr. Bohnsack, Baylee showed persistent inflammation in her ankles, knee, elbow, wrist and toe.  The decision was made to add Enbrel (Enteracept) to her regimen.

Baylee’s arthritis was controlled on Enbrel, but she never did enter into remission. She was doing well enough to have the Enbrel discontinued in March of 2008.

In June of 2008, because of active arthritis in 2 joints and active arthritis, she began using Humira (Adalimumab) in conjunction with her Methotrexate.  In order to help control her inflammation, she also began taking Meloxicam.

Baylee remained on Humira and Methotrexate until June of 2010.  The Meloxicam had been discontinued because of abnormal blood tests.

After a flare up of both her arthritis and uveitis, Dr. Bohnsack consulted with Dr. Albert Vitale and together, they made the decision to start her on Remicade. 

Remicade was chosen in part because of the ability to adjust it according to the activity of her disease.

Baylee received Remicade treatment, covered under Intermountain Healthcare, until July 2011 when our family relocated to Missouri.

Upon our arrival in Missouri, we consulted with new physicians at St. Louis Children’s Hospital.  Dr. Andrew White, Rheumatologist, agreed with the previously prescribed treatment and continued the Remicade in combination with Methotrexate. 

Baylee’s treatment continued uninterrupted covered under insurance (through Cigna) until December of 2011.

I have included copies of Dr. John Bohnsack's examination notes and notes from the Department of Rheumatology at St. Louis Children’s Hospital (which were already submitted).

I ask you to consider appeal on the basis of Medical Necessity because through her medical history we have used the other two TNF inhibitors approved by the FDA without long term positive results.

After thorough research, the majority of insurance companies initially do not cover Remicade unless it can be proven that other TNF inhibitors have failed to control the disease, at which point it is covered.

I believe we followed standard treatment protocol for Baylee’s Juvenile Rheumatoid Arthritis, and throughout the course of treatment exhausted other stepped forms of treatments.  The course of treatment for Baylee was not considered lightly.  Several doctors who are specialists in their fields and in multiple locations (Primary Children’s Medical Center and St. Louis Children’s Hospital) were consulted and came to agreement that Remicade was the appropriate next step in her treatment.

I would respectfully request you approve the Remicade treatment to manage Baylee’s Juvenile Rheumatoid Arthritis and honor the health coverage and benefits as outlined by multiple representatives of United Healthcare.  Treatment was only continued on the basis of information provided, a history of coverage through other carriers and most importantly, the medical necessity of treatment to the long term care and quality of life for Baylee.

I appreciate your consideration.

Sincerely,

Wendy Morgan

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